Individual
MICHELE CASEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
368 TIOGA AVE, KINGSTON, PA 18704-5117
(570) 287-9681
Mailing address
368 TIOGA AVE, KINGSTON, PA 18704-5117
Taxonomy
Speciality
Code
Description
License number
State
252Y00000X
Early Intervention Provider Agency
Primary
OC002871L
PA
Other
Enumeration date
11/02/2010
Last updated
11/02/2010
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